FOCUS ON: Ankle Sprains

For Immeidate Release, Health Topic Article

01/11/2010




Ankle sprains are one of the most commonly reported injuries in high school and college sports. According to a National Collegiate Athletic Association (NCAA) study, ankle sprains accounted for almost 15% of all injuries reported. In select sports such as basketball, sprains account for nearly 25% of all injuries reported.

 
A sprain is an injury to a ligament, the non-elastic connective tissue that runs between bones. Almost 80-90% of ankle sprains occur to the ligaments on the outside, or lateral side, of the ankle. Stepping on a rock or in a hole, or the classic example of landing on the foot of another player, are some of the most frequent descriptions of how the injury occurs. This action results in the foot being forced inward and down, spraining the outside ligaments.
 
 
The severity of an ankle sprain is based on the amount of damage to the ligament.  A grade 1 sprain indicates mild stretching of the ligament fibers without significant tearing. Typically this type of injury causes some swelling and pain. A grade 2 sprain involves more extensive stretching of the ligament fibers plus some tearing of individual fibers. A person diagnosed with this sprain grade will experience more extensive pain and swelling as well as discoloration. The most significant sprain, a grade 3 sprain involves severe tearing of the ligament with significant pain swelling and discoloration of the ankle.

Any ankle sprain suspected of being a grade 2 or grade 3 should be x-rayed to rule out a possible fracture. The exception to this is with younger children and adolescents who are still growing; they are more likely to injure the bone at the growth plate. Injuries in these individuals should be looked at with a higher suspicion of having a growth plate fracture if they have a significant ankle injury.
 
Symptoms of an ankle sprain include pain, swelling, discoloration, decreased range of motion and decreased ability to bear weight on the ankle; occasionally a “pop” sensation may also be felt. Standard initial treatment should include R.I.C.E.--rest, ice, compression, and elevation. This approach is used to limit the amount of swelling and pain. Ice should be applied for 15-20 minutes at a time with approximately 1 hour between applications. This is repeated as many times as is convenient. Compression should be done with an elastic wrap, such as an ace bandage, from the toes to the middle of the lower leg. Compression should not be so tight as to cut off circulation. Ideally, elevation would place the injured ankle above the level of the heart. This practice should be followed for at least the first 48-72 hours after a fresh injury.
 
Once the acute phase of the injury has passed and it has been determined there is no fracture present, rehabilitation may begin. Generally this begins with gentle range of motion exercises and stretching. This will eventually progress to strength and balance exercises to regain muscle control. Return to play is based on the individual's ability to perform safely and without pain during functional testing. Taping and bracing may be considered during this phase of recovery as well. It should also be understood that even though one is able to perform without pain or swelling, the healing process for sprains can take several months to be complete.
 
 

Contact Information
Vin Faraci
Certified Athletic Trainer
Copley Hospital Rehabilitation Services